O.T. Gleason 6

[Earl Gray]

Anyone else been diagnosed?

To treat or not to treat?

[rupnok]

How old? How healthy? How many positive cores? Volume of cores positive? PSA?

[schneiderrd]

In addition, how are the cores distributed. ie in one area or spread through out. Also are any close to the prostate wall? I was a Gleason 6 (3+3). Since I was relatively young at the time I decided to go for treatment. No regrets.

[Earl Gray]

How old? How healthy? How many positive cores? Volume of cores positive? PSA?

46. Otherwise Healthy. 1 positive- 3%, 1 suspicious. PSA were very low (3ish I think)


In addition, how are the cores distributed. ie in one area or spread through out. Also are any close to the prostate wall? I was a Gleason 6 (3+3). Since I was relatively young at the time I decided to go for treatment. No regrets.
Only got results from urologist yesterday (on april fools). Don't know or fully understand other details.

What form of treatment?

[schneiderrd]

Because all 12 cores showed the same level, I decided on prostatectomy. I also had it done by robotic surgery(Da Vinci). They say the out comes are the same for the robot vs conventional, but the recovery from the robot is much easier. Could have gone back to work in two weeks but took four (actually drove home from the hospital the day after surgery).

You are a lot younger than I was when I was diagnosed. For sure get a second opinion and do your homework. There is a ton of information on the web. You may decide to keep an eye on it for awhile to see if it is growing.

It looks like yours may not be as wide spread as mine but if you decide to go for treatment you may want to look at some of the other treatment options. Just be aware that all of the options have advantages and disadvantages.

What ever you decide, it looks like you picked it up early so don't panic. You are ahead of the curve and have time to decide what to do.

Good luck

[oldguy00]

My father went through this over the past few years (gleason 9 & 10, stage 3).
Feel free to PM me if you'd like to chat, I've pretty much spent the last 3 years researching on his behalf.
A really good, really active forum is:
http://www.healingwell.com/community/default.aspx?f=35

[MadRocketSci]

Disclosure: I am an investor in the product I am about to talk about.

You might want to look into Provenge - it is an immunocellular therapy for prostate cancer, and to me there is evidence that it is most effective at early stages when immunity is strong. Basically, it is a procedure that trains your immune system to recognize and attack cells that express PAP (prostatic acid phosphatase) which is expressed by 95% of prostate cancer cells. The side effect profile is very benign compared to other treatments.

Unfortunately it is only FDA approved for late stage prostate cancer, as trials for cancer treatments usually go to that patient group. The early stage effectiveness is something that is being investigated but currently only an academic discussion.

Anyway, I encourage you to learn more about it.

http://en.wikipedia.org/wiki/Sipuleucel-T

http://www.provenge.com

[oldguy00]

Unless he has $93k to spend on treatment, provenge probably ain't gonna be in the cards. Given his early stage, I doubt any amount of fighting will get his insurance to cover it. But I guess it doesn't hurt to ask!

[schneiderrd]

If someone is actually doing a trial on Provenge for early stage cancer, and you can get in to that program, there should be no cost.

[oldguy00]

If someone is actually doing a trial on Provenge for early stage cancer, and you can get in to that program, there should be no cost.


As MadRocket mentioned, it is only being discussed for early stage, not in trials yet I don't think.

[rupnok]

For your awareness, I am a Urologist and an investor in Provenge so here is my opinion.

If only one core positive with Gleason six and only 3% involved I would strongly consider active surveillance. This means you will keep an eye on your PSA and get another biopsy in perhaps a year and if progressing then you could consider treatment. Prostate cancer is generally slow growing, especially the low grade type like you have. You could theoretically live forever with what you have on the biopsy. The problem is always that a biopsy is just a sampling of your prostate so you never know if you just missed a larger area of cancer or a more aggressive grade. The treatment for prostate cancer does have side effects, i.e. impotence, incontinence, bowel/bladder frequency/urgency so it is not something to rush into. There are treatments for most of the adverse events but you will never be the same as you are now. Your urologist will obviously talk to you in detail about this and only he knows everything needed to guide your treatment.

Provenge is for metastatic hormone refractory prostate cancer which you do not have at this point. It is NOT a first line treatment so is by no means an option for you.

[Louis]

Do you guys not feel a bit uncomfortable investing in the same products you might be prescribing?

[Ken Robb]

I feel good investing in things I believe in.

[Viper]

Post # 11 rang true for my Father.

His situation was very close to the OP's. W&W, wait and watch was the final call (after being told many other courses of action). After a biopsy, he wound up on hormone therapy, then radiation. He is fine.

http://www.watchwait.com/gleason_6.php

Earl Gray, everyone's dumped a lot of data and actions. Here's the main thought: be strong, smart, well, take care and you will be just fine man.

[Louis]

I feel good investing in things I believe in.

Perhaps, but that doesn't do much to dispel concerns of a conflict of interest.

[rupnok]

Do you guys not feel a bit uncomfortable investing in the same products you might be prescribing?

I don't prescribe Provenge. Usually those who would be candidates for it are under the care of either an Medical Oncologist or Urologic Oncologist of which I am neither. I bought the stock on a whim and own very very little of it. But your statement is a good one - kind of why drug reps are no longer to spend so much money on physicians anymore.

[Earl Gray]

Thanks for all the advise and support. I see the next Dr on the 24th and will see how it goes. Hopefully active surveillance will be what I do for years to come.

[oldguy00]

Thanks for all the advise and support. I see the next Dr on the 24th and will see how it goes. Hopefully active surveillance will be what I do for years to come.

Cool, good luck. Not really any wrong choices IMHO, so be happy with whatever direction you choose and don't dwell on it. Very very good chance that you have a long life ahead of ya.